Immunohistochemical surfactant protein-A expression: Fatal drowning vs. postmortem immersion

Stemberga, Valter; Štifter, Sanja; Cuculić, Dražen; Čoklo, Miran; Bosnar, Alan

doi:10.1016/j.mehy.2008.11.024

Cited by 21 publications

(10 citation statements)

References 13 publications

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“…In this respect, SP-A immunohistochemistry can be a very useful indicator of respiratory distress and alveolar injury but SP-A immunohistochemical expression alone cannot have diagnostic value in differentiating asphyxia and drowning as well as NDs and fatal poisoning. According with other Authors [23,41] it should be preferably associated with the presence and intensity of histological signs such as, atelectasis and/or emphysema, congestion, hemorrhage, and edema in particular. Congestion and pulmonary edema are very common pathological findings in natural and violent deaths as well as in any death associated with agonal heart failure affecting SP-A immunohistochemistry based on type and amount of intra-alveolar fluid and its pathogenesis (cardiogenic and non-cardiogenic).…”

Section: Resultsmentioning

confidence: 98%

“…SP-A immunohistochemistry alone cannot differentiate among fatalities [23] since it can be also affected by internal or external fluid accumulation in the lung alveoli according with severity of primary or secondary respiratory distress.…”

Section: Discussionmentioning

confidence: 99%

“…Increase of the membranous or linear SP-A staining on the intra-alveolar surface or at the interface has been indicated as an increase of surfactant secretion due to various fatal stresses among which acute myocardial infarction and carbon monoxide (CO) intoxication [20][21][22]. However, SP-A has been also observed in a different immunohistochemical distribution pattern such as aggregated granular staining distributed both intracellular and extracellular in the intra-alveolar space but the exact mechanism of massive aggregates production remains to be determined [23].…”

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confidence: 99%

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An immunohistochemical study of pulmonary surfactant apoprotein A (SP-A) in forensic autopsy materials

Campobasso¹,

Colonna²,

Zotti³

et al. 2012

RJLM

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SP-A is the most prevalent protein component of pulmonary surfactant which is essential to maintain alveolar stability. SP-A can be detected by immunohistochemistry and in such form it has been previously reported as a useful tool to distinguish aspyxial deaths from other hypoxic cases. The present immunohistochemical study shows the SP-A staining distribution among a selected forensic material to evaluate the effect of fluid accumulation in the lung interstitium and alveoli commonly related to pulmonary edema. A total of 48 cases were examined histologically and immuno-histochemically based on the presence/absence of pulmonary edema and survival time: 10 cases of acute cardiac deaths (ACDs) in which death occurred rapidly, in a few minutes from the beginning of the symptoms and without signs of pulmonary edema, 18 cases of drowning (12 in saltwater and 6 cases in freshwater), 20 cases of narcotic deaths (6 by cocaine and 14 by opiates) with gross pulmonary edema. The results suggest that edema fluid can produce some kind of molecular alterations of SP-A affecting immunostaining expression. The results show also that SP-A immunostaining patterns alone do not meet the requirements for general diagnostic use and cannot differentiate among fatalities. The SP-A expression needs to be preferably associated with the presence and intensity of histological signs according to suspected cause of death as well as type and amount of edema fluid commonly related to cardiac and/or respiratory failure (cardiogenic and non-cardiogenic pulmonary edema).

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Section: Resultsmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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An immunohistochemical study of pulmonary surfactant apoprotein A (SP-A) in forensic autopsy materials

Campobasso¹,

Colonna²,

Zotti³

et al. 2012

RJLM

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“…Immunohistochemical detection of SP-A even might be utilized for forensic purposes helping to distinguish between fatal drowning and postmortem immersion [ 45 ].…”

Section: Reviewmentioning

confidence: 99%

On the significance of Surfactant Protein-A within the human lungs

Goldmann

Kähler

Schultz

et al. 2009

Diagnostic Pathology

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Surfactant Protein-A (SP-A) is the most prominent among four proteins in the pulmonary surfactant-system. SP-A is expressed by alveolar epithelial cells type II as well as by a portion of non small cell lung carcinomas (NSCLC).The expression of SP-A is complexly regulated on the transcriptional and the chromosomal level. SP-A is a major player in the pulmonary cytokine-network and moreover has been described to act in the pulmonary host defense.By the use of cell culture or animal models the functional properties have been repeatedly shown in many aspects, often bearing surprising properties which strongly indicate the physiological importance of SP-A. To date SP-A is recognized as a molecule essential for pulmonary development, structure and function. An upcoming number of reports deals with the role of SP-A for pulmonary pathology. This article gives an overview about the state of knowledge on SP-A focused in applications for human pulmonary disorders and points out the importance for pathology-orientated research approaches using immunohistochemistry or in situ hybridization as promising methods to further elucidate the role of this molecule in adult lung diseases.

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“…In some cases, like asphyxia and drowning, they are often the only tools to give a diagnostic indication. An ideal diagnostic marker for drowning still needs to be developed, but some authors have recently studied SP-A as the marker of asphyxiation, drowning and respiratory distress syndrome concluding that SP-A is not fully specific for drowning but is a good marker of alveolar injury [3]- [8]. However, experimental studies have shown an in-crease of SP-A expression in asphyxia, suggesting its use as a marker [9].…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Immunohistochemical Detection of Surfactant Protein A (SP-A) in Fatal Drowning

Dominicis¹,

Santeusanio²,

Milano³

et al. 2016

FMAR

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L'annegamento rimane ancora una delle diagnosi più difficili della patologia forense perché i risultati macroscopici e microscopici dell'autopsia sono aspecifici. Un marker diagnostico ideale per annegamento deve ancora essere sviluppato, ma alcuni autori hanno recentemente studiato l'SP-A come marcatore di soffocamento e annegamento. Lo scopo di questo studio è quello di confrontare le caratteristiche istopatologiche e la SP-A espressione immunoistochimica nei tessuti polmonari in caso di annegamento con quelli determinati da altre cause di discriminare tra sommersione di cadavere e annegamento.Drowning still remains one of the most difficult diagnoses in forensic pathology because macroscopic and microscopic autopsy findings are unspecific. An ideal diagnostic marker for drowning still needs to be developed, but some authors have recently studied SP-A as a marker of asphyxiation and drowning. The aim of this study is to compare the histopathological features and the SP-A immunohistochemical expression in lung tissue in the case of drowning with those determined by other causes to discriminate between cadaver submersion and drowning

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Immunohistochemical surfactant protein-A expression: Fatal drowning vs. postmortem immersion

Cited by 21 publications

References 13 publications

An immunohistochemical study of pulmonary surfactant apoprotein A (SP-A) in forensic autopsy materials

An immunohistochemical study of pulmonary surfactant apoprotein A (SP-A) in forensic autopsy materials

On the significance of Surfactant Protein-A within the human lungs

Pulmonary Immunohistochemical Detection of Surfactant Protein A (SP-A) in Fatal Drowning

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